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Pitt Researchers Develop New Survey Tool to Measure EMS Teamwork

PITTSBURGH, Dec. 1, 2011 – Investigators at the University of Pittsburgh have developed the first survey tool that may help to identify poor teamwork and optimize crew pairings to improve safety in emergency medical services (EMS). The survey is described in an article now available online in Prehospital Emergency Care and scheduled to be published in the January-March print edition.

Teamwork is critical to safe and effective care in EMS, where paramedics typically work in pairs to stabilize and transport patients, often in dangerous and unpredictable environments, said lead author P. Daniel Patterson, Ph.D., EMT-B, assistant professor of emergency medicine at the University of Pittsburgh School of Medicine.

“Teams of EMS providers work in pairs, and each provider annually has 19 new partners on average, with some having more than 50,” he said. “Frequent turnover of partners can affect the team’s ability to develop positive teamwork behaviors. Trust and other components of teamwork are vitally important in the EMS environment where stress, fatigue and unpredictability are common and are known threats to patient and provider safety.”

The study, designed to develop the survey tool and then validate it, involved emergency medical technicians (EMTs) and paramedics from 39 EMS agencies across the United States. Referencing their most recent partnership,   participants answered questions that addressed team leadership, partner communication, trust, adaptability and conflict. That information was used to design the EMT-TEAMWORK survey tool, which involved a unique collaboration among researchers at the University of Pittsburgh and Carnegie Mellon University and Eduardo Salas, Ph.D., the University of Central Florida’s renowned expert on teamwork measurement for the military.

Analysis of 687 completed questionnaires  determined that the EMT-TEAMWORK survey tool is a reliable and valid means of measuring nine components of teamwork that, in other settings, have been found to affect safety, quality and performance.

“Despite the importance of teamwork in EMS, very little is known about how well EMS teams work together, what improves or derails teamwork, and what the implications are for conflict between EMS partners. EMS teams need to be studied over time to recognize changes in survey scores and to test hypothesized associations between partner teamwork and safety outcomes,” said Dr. Patterson. “Further studies may help to determine which survey scores indicate that threats to patient and provider safety are elevated. We believe that our EMT-TEAMWORK survey will prove to be an effective and easy-to-use tool to assess the impact that teamwork has on safety outcomes in EMS.”

Other study authors are Matthew D. Weaver, Donald M. Yealy, M.D., Robert M. Arnold, Ph.D., and Judith R. Lave, Ph.D., of the University of Pittsburgh; Sallie J. Weaver and Dr. Salas, of the University of Central Florida; Michael A. Rosen, Ph.D., of Johns Hopkins University; and Gergana Todorova, Ph.D., Laurie R. Weingart, Ph.D., and David Krackhardt, Ph.D., all of Carnegie Mellon University.

The study was supported by the National Center for Research Resources, the North Central EMS Institute and Pittsburgh Emergency Medicine Foundation.

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